Ramblings of an Emergency Physician in Texas

Don’t open wide: Annual check-ups are pretty much useless

I suspect this underestimates the problem. I think a lot of ‘chasing incidentalomas’ in medicine start here:

Two doctors in Colorado scanned through 14 randomized, controlled studies involving 182,000 patients. The articles spanned from 1963 to 1999. The doctors looked at whether those who had regular check-ups had higher mortality rates than their counterparts who dodged such visits. They could not find a difference.“General health checks do not improve important outcomes and are unlikely to ever do so based on the pooled results of this meta-analysis spanning decades of experience,” write authors Allan Prochazka and Tanner Caverly. ”There remains a belief in the value of general health checks despite the accumulating evidence. This belief is buoyed by screening advocacy groups and insurance coverage, and they have ramifications for patient welfare and health care costs.”

They point out that Canada actually stopped paying for ‘routine checkups’ in 1979.

(Please understand I’m not including chronic condition maintenance in this category, like CHF or diabetes visits, as once you’ve got a chronic condition that’s where office visits probably really do help).

Comments

“They point out that Canada actually stopped paying for ‘routine checkups’ in 1979.”

I kinda thought that Canadian Healthcare was geared more to saving money than helping patients??

Since I have a check-up this week I’m interested in this. As an American male with experience in this area I’ve decided that if nothing else an annual checkup allows me to bring concerns to my family doc that might not otherwise come out.
In my experience (28 years in the military) guys are generally and sometimes fatally stoics; they bottle s**t up and tough it out because that’s what they’ve/we’ve been told all our lives growing up. We don’t tell wives and we don’t make special visits to see the doctor. As a result, some of us have died.
I have learned to use my checkups to bounce what might seem like minor ailments that have built up over the year off my family doc, however silly.
In the process I have discovered that on occasions I have been recklessly indifferent about my health and certain warning signs (yes, I exercise and lost weight GD, a lot of weight!) and only when I mentioned them to my doctor did I learn just how reckless I had been.
On the other hand who knew that a problem swallowing was a relatively simple fix? Gawd, it’s good to be able to drink a beer again!!!
Are they necessary? I dunno, maybe not, but they have served as safety valve for me and I’d hate to lose them.
P.S. I’m not a physician, nurse nor a physician’s spokesperson but I am a gen-u-wine, American layman………;-)